Operations are being cancelled because of dirty or broken instruments sent back by private companies employed to clean them, the Royal College of Surgeons (RCS) informed Health Direct.

Hospitals used to sterilise their operating instruments on site but are being encouraged by the Department of Health to put the job out to private companies.

A survey of surgeons found that equipment was often unfit for use, damaged, or late – meaning that operations were cancelled at the last minute, often when patients were already

Two thirds of surgeons questioned by the RCS were unhappy with the availability and condition of instruments sent away for sterilisation.

The survey showed that 70 per cent of paediatric surgeons using outside firms were unhappy about it. The same was true for 82 per cent of neurosurgeons, 79 per cent of ear, nose and throat surgeons and 60 per cent of plastic and reconstructive surgeons.

Decontamination of instruments is essential to prevent the spread of infection.

Thirty-two per cent of plastic surgeons were not happy with the level of sterility, as were 30 per cent of ear, nose and throat surgeons, 28 per cent of neurosurgeons and 28 per cent of paediatric surgeons.

When it came to equipment being maintained in good condition, 70 per cent of paediatric surgeons were not happy with the service along with 85 per cent of neurosurgeons and 84 per cent of plastic surgeons.

Surgeons using in-house decontamination services were not satisfied with some aspects of this equipment care.

The RCS said that although private firms largely succeeded in sterilising kit, too much came back late or went missing. Sensitive, expensive tools were being broken, a statement said.

“Without the equipment to do the job, surgeons are forced to cancel or abandon operations – sometimes when patients are anaesthetised and prepared.”

Prof Richard Ramsden, who collected the evidence, said: “Operations are delayed because vital tools are not available. Surgeons working with on-site instrument cleaning facilities are getting a better service, enough to warrant an urgent reassessment of what’s best for the NHS.”

Bernard Ribeiro, the RCS president, said: “This is yet another example where something that looks good on paper in Whitehall gets rolled out without adequate professional consultation and piloting.”

A Department of Health spokesman said that more than £200 million had been invested in improving decontamination services since 2001.